Provider Demographics
NPI:1427347954
Name:ANDREWS, SANDRA (RD, CDE)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:
Last Name:ANDREWS
Suffix:
Gender:F
Credentials:RD, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2121 SANTA MONICA BLVD
Mailing Address - Street 2:DEPT OF NUTRITION & DIABETES EDUCATION
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404-2303
Mailing Address - Country:US
Mailing Address - Phone:310-829-8077
Mailing Address - Fax:310-315-6131
Practice Address - Street 1:2121 SANTA MONICA BLVD
Practice Address - Street 2:DEPT OF NUTRITION & DIABETES EDUCATION
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-2303
Practice Address - Country:US
Practice Address - Phone:310-829-8077
Practice Address - Fax:310-315-6131
Is Sole Proprietor?:No
Enumeration Date:2011-04-05
Last Update Date:2011-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA609568133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered